Endoscopic surgical techniques have been used successfully to perform a variety of surgical procedures including vagotomies, appendectomies, laparotomies, gall-bladder removals, lysis of adhesions from scar tissue, and hernia repairs, in addition to many other operations.
The use of endoscopic surgical procedures can provide benefits over conventional surgical techniques to both the surgeon and the patient. The time required to perform endoscopic surgery is often significantly less than the time required to perform the same operation using conventional surgical techniques. In addition, endoscopic procedures decrease the amount of pain and discomfort suffered by the patient while also decreasing the recovery time and the amount of scarring.
However, endoscopic surgical procedures are hampered because such procedures require the use of specialized tools in order to effectively work in an endoscopic surgical environment. Since only a small incision is made in the patient, the surgeon's access to the operating site is restricted. Therefore, new instruments are needed when working in an endoscopic environment.
Devices for endoscopically closing hernia defects have been developed and can be broadly classified as either stapling or suturing devices. Although sutures are cheaper and less likely to cause adverse reactions, current suturing devices suffer in that they do not securely clamp the suture and the suture is difficult to mount within the device. Furthermore, existing devices make it difficult to place the sutures in the operating site at the optimal locations for suture passing and tying. As a result, endoscopic suturing techniques generally require longer operating times than do stapling techniques.
U.S. Pat. No. 4,923,461 relates to a method for arthroscopic suturing of tissue within the body without requiring open surgery. The method involves penetrating the tissue to be sutured with a hollow needle and feeding the suture material through the hollow needle. The needle is then removed and the suture knotted. However, this method has the disadvantage of having to clamp onto the suture end and withdraw it from the body in order to knot the suture. In addition, this method cannot be used to provide a running seam. Further, the device necessary to perform such a procedure is bulky and, therefore, restrictive in use.
Accordingly, it would be highly desirable to have an endoscopic suturing device that is easy to use, easy to manipulate, and securely clamp the suture, and wherein the suture is easily mounted within the suture passer. In use, the suturing device should enable placement of the sutures at optimum locations in the operating site and desirably enable tying of the sutures subcutaneously.